Rebate

NOTE: We are now operating under the new Government CCMS system meaning registered parent must supply THEIR date of birth plus CRN numbers for themselves & child and be CCB current or No CCB can be claimed. If claiming CCB% we will calculate fees and advise you.

Are you claiming FAO CCB% rebate?

YesNo

Parent who child is registered to

DOB

CRN

Please tick who registered to

MumDad

Health Details

Child/ren fully immunised?

Child 1 *

YesNo

Child 2

YesNo

Child 3

YesNo

Name of child/ren's doctor or nearest hospital/medical centre

Details of children's health

Parent/Carer Details

Mother/Carer's Name

Father/Carer's Name

Other persons authorised to collect your children

Any Court Orders we need to be Aware of?

YesNo

Waiver

Waiver (please tick) *

I understand that the activities require physical activity and acknowledge that my child's physical condition permits him/her to safely participate. Participants are advised that they enter the FFS program at their own risk. I give Fun Fit Sports the authority to seek medical help for my child/ren in case of accident and for my children to attend the nominated excursions on Tuesday 2nd January 2018, (Swimming-CISAC, Belconnen from 10:30am-3:30pm) , Thursday 4th January 2018 (Iplay - Westfield Belconnen), Tuesday 9th January 2018 (Bowling, AMF Tuggeranong, 10:30am-2:00pm), Thursday 11th January 2018 (Inflatable World, Kambah, 10:30am-2:00pm), Tuesday 16th January 2018 (Swimming-YMCA, Tuggeranong from 10:30am-3:30pm) , Thursday 19th January 2018, (Mini Golf King - Canberra Outlet Center), Tuesday 23rd January 2018 (Inflatable World, Kambah, 10:30am-2:00pm) Thursday 29th January 2018 (AIS Sportex Tour, Bruce, 10:30am-2:00pm), Tuesday 30th January 2018 (Swimming-CISAC, Belconnen from 10:30am-3:30pm), Thursday 1st February 2018 (Bowling, AMF Tuggeranong, 10:30am-2:00pm). I understand that payment is required on or before my child's first day. Any outstanding amount will be deducted from my nominated credit card at the completion of my child's attendance.I accept